ER Positive Breast Cancer in Older Women — Clinical Challenges and Evolving Evidence for Screening and Treatment

January 15, 2022

In January 2022, a multidisciplinary team of breast cancer researchers from UPMC Hillman Cancer Center, UPMC Magee-Womens Hospital, and the Magee-Womens Research Institute published a new review article on estrogen-receptor positive (ER+) breast cancer in older women in the journal The Lancet Healthy Longevity.

This new, comprehensive review presents an assessment of the evolving screening, staging, and treatment paradigms for older women (> 70 years of age) with ER+ breast cancer. 

The UPMC and University of Pittsburgh team discuss at length the unique clinical considerations for screening, detection, and treatment of estrogen receptor-positive tumors, which typically are low-risk, grow much slower than other varieties of breast tumors and are often not the primary cause of death in this patient population. 

The review highlights important areas of consideration for clinicians when faced with managing these types of tumors in older women, particularly related to avoiding overtreatment, and what circumstances are suggestive for de-escalating care for some patients.

The paper also considers how new basic science and translational research findings are shaping the evolving treatment paradigm for this disease. They discuss the growing evidence for how a pro-inflammatory state in the aging body may influence tumor characteristics and growth and how some existing compounds such as statins, aspirin therapy, and metformin may prove useful in combatting systemic inflammatory profiles or act as chemo-protective agents.

The research team also notes that a continuing drive toward more personalized treatment approaches is a priority for clinicians. These approaches should emphasize improved screening and diagnostic modalities, and eventual treatment options when warranted that balance a patient's goals of care and quality of life.

Read the entire review article at the reference below. 

Reference

Carleton NC, Zasrazadani A, Gade K, Beriwal S, Barry PN, Brufsky AM, Bhargava R, Berg WA, Zuley ML, van Londen GJ, Marroquin OC, Thull DL, Mail PL, Diego EJ, Lotze MT, Oesterreich S, McAuliffe PF, Lee AV. Personalizing Therapy for Early-Stage Oestrogen Receptor-Positive Breast Cancer in Older Women. Lancet Healthy Longev. 2021 Dec 13; 10:21. Epub ahead of print.